Subjective and objective cognitive functioning in untreated late-life depression: An exploration centered on comorbid generalized anxiety disorder

IF 4.3 2区医学 Q1 PSYCHIATRY Comprehensive psychiatry Pub Date : 2024-04-26 DOI:10.1016/j.comppsych.2024.152490

Fugui Jiang , Jing Zhang , Yang Yi , Arui Tan , Xiaohong Qin , Peijia Wang , Xuemei Zhong , Jun Xiao , Jieying Li , Bo Zhou

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Abstract

Background

Late-Life Depression (LLD) is a prevalent mental health disorder that is often accompanied by cognitive impairments. The objective of this study is to investigate the influence of coexisting Generalized Anxiety Disorder (GAD) on both subjective and objective cognitive abilities in untreated LLD individuals.

Methods

A total of 77 participants aged 60 years and above were recruited for this study, comprising 31 individuals with Major Depressive Disorder (LLD group), 46 with MDD and coexisting Generalized Anxiety Disorder (LLDA group), and 54 healthy controls (HC). Prior to the study, all patients had abstained from psychotropic medication for a minimum of two weeks. Comprehensive neuropsychological assessments were administered to all participants.

Results

The LLDA group exhibited substantial disparities in memory, attention, processing speed,executive function,overall cognitive functioning, and subjective cognitive functioning when compared to the HC group. The LLD group displayed deficits in memory, SCWT-W in attention, SCWT-C in processing speed,overall cognitive functioning, and subjective cognitive functioning in comparison to the healthy controls. Although the LLD group achieved lower average scores in executive function, TMTA in processing speed, and DSST in attention than the HC group, no significant distinctions were identified between these groups in these domains. Linear regression analysis unveiled that anxiety symptoms had a significant impact on subjective cognitive deficits among MDD patients, but exhibited a milder influence on objective cognitive performance. After adjusting for the severity of depression, anxiety symptoms were found to affect TMTA in processing speed and subjective cognitive functioning in LLD patients.

Conclusion

Late-Life Depression (LLD) exhibits pervasive cognitive impairments, particularly in individuals with generalized anxiety disorder, presenting a crucial target for future therapeutic interventions. Among elderly individuals with depression, anxiety symptoms significantly impact subjective cognitive functioning, suggesting its potential utility in distinguishing between depression-associated cognitive decline and pre-dementia conditions.

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未经治疗的晚年抑郁症患者的主观和客观认知功能：以合并广泛性焦虑症为中心的探索

背景晚年抑郁症（LLD）是一种常见的精神疾病，通常伴有认知障碍。本研究的目的是调查并存的广泛性焦虑症（GAD）对未经治疗的晚年抑郁症患者的主观和客观认知能力的影响。方法本研究共招募了 77 名 60 岁及以上的参与者，其中包括 31 名重度抑郁症患者（晚年抑郁症组）、46 名 MDD 和并存的广泛性焦虑症患者（晚年抑郁症组）以及 54 名健康对照组（HC）。研究前，所有患者均已停用精神药物至少两周。结果与健康对照组相比，LLDA 组在记忆力、注意力、处理速度、执行功能、整体认知功能和主观认知功能方面表现出明显的差异。与健康对照组相比，LLD 组在记忆力、SCWT-W 注意力、SCWT-C 处理速度、整体认知功能和主观认知功能方面存在缺陷。虽然 LLD 组在执行功能、处理速度 TMTA 和注意力 DSST 方面的平均得分低于 HC 组，但两组在这些领域并无显著差异。线性回归分析表明，焦虑症状对 MDD 患者的主观认知缺陷有显著影响，但对客观认知表现的影响较小。在对抑郁症的严重程度进行调整后，发现焦虑症状会影响晚年抑郁症患者的 TMTA 处理速度和主观认知功能。在患有抑郁症的老年人中，焦虑症状会对主观认知功能产生重大影响，这表明焦虑症状在区分抑郁症相关认知功能下降和痴呆症前期症状方面具有潜在作用。

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来源期刊

Comprehensive psychiatry 医学-精神病学

CiteScore

12.50

自引率

1.40%

发文量

审稿时长

29 days

期刊介绍： "Comprehensive Psychiatry" is an open access, peer-reviewed journal dedicated to the field of psychiatry and mental health. Its primary mission is to share the latest advancements in knowledge to enhance patient care and deepen the understanding of mental illnesses. The journal is supported by a diverse team of international editors and peer reviewers, ensuring the publication of high-quality research with a strong focus on clinical relevance and the implications for psychopathology. "Comprehensive Psychiatry" encourages authors to present their research in an accessible manner, facilitating engagement with clinicians, policymakers, and the broader public. By embracing an open access policy, the journal aims to maximize the global impact of its content, making it readily available to a wide audience and fostering scientific collaboration and public awareness beyond the traditional academic community. This approach is designed to promote a more inclusive and informed dialogue on mental health, contributing to the overall progress in the field.